Private Health Insurance - Do I Need It For Surgery?
Insured
Most health funds cover bariatric (weight-loss) surgery, however, you will usually need to be in a high level of cover.
Patients with an appropriate level of private health insurance cover will find most hospital and equipment charges will incur a “no gap” fee. The out of pocket expenses for insured patients relate mostly to professional and clinic fees charged by the surgeon, anaesthetist and their assistants. Occasionally, in your operation, there may be certain equipment used which is “non-rebateable,” such as the lap band device.
To check, simply contact your health fund and quote the relative surgery ‘item numbers’ listed.
Sleeve Gastrectomy
Item No. 31575
Gastric Band
Item No. 31569
Gastric Bypass
Item No. 31572
Revisional Surgery
- Band to Sleeve (Single Stage)
Item No. 31584
- Band to Bypass (Single Stage)
Item No. 31584
- Band to Sleeve (2 Stage)
Item No. 31585, 31584
- Band to Bypass (2 Stage)
Item No. 31585, 31584
Uninsured
If you are NOT INSURED for weight loss surgery, we have multiple payment options for you. This includes:
Interest Free Payment Plans
Early Release of Superannuation
Procure/Upgrade Private Health Insurance
Self-funded
Interest Free Payment Plans
North Eastern Weight Loss Surgery understands the financial pressure associated with having weight loss surgery. ZipPay makes it possible for you to spread the cost with an interest-free period available and flexible payment options tailored to your needs.
Please call our friendly team on 03 9895 7215 to discuss how ZipPay can work for you!
Procure/Upgrade Private Health Insurance
You may choose to procure or, upgrade your level of Private Health Insurance which will generally incur a 12-month waiting period. To qualify for weight loss surgery, you will usually require top/gold level cover. Once you have made the decision to have weight loss surgery, there are many things that can be done to prepare.
Here at NEWLS, we can help set out an individual plan to help make the most of any private insurance waiting periods so you are ready to go once insurance is good.
Early Release of Superannuation
Gaining access to your superannuation to undergo surgery is an option. There are, however, a few things that should be carefully considered prior to accessing your super that may/will affect your retirement income.
When money is withdrawn from your superannuation account, the government will apply a 20% tax on the amount requested e.g. if $10,000 is requested, $12,000 will be deducted - $2,000 will be the tax you must pay. Any funds that are withdrawn also need to be added to your end-financial year taxable income for taxation purposes. This may push some people into the next taxation bracket and you may find that you will need to repay money to the ATO. The extra funds can also affect Centrelink payments (eg. family tax benefit, parenting payments & childcare funding) and you may find you have been overpaid or, are no longer eligible.
Accessing superannuation should be carefully considered and NEWLS always recommends seeking financial advice to discuss personal financial circumstances/tax implications.
In some circumstances, after the initial consultation and discussion with the surgeon, self-funding may be considered. Self-funding is an option for those who want to pay for surgery immediately and don't want to apply for private health insurance and incur waiting periods. As a self-funding patient, you will be responsible for all hospital costs prior to admission and these are not covered by Medicare.
Costs include (but are not limited to): • Hospital Fees • Theatre Fees • Surgical Equipment • Pathology/Radiology Fees • Professional Fees (Surgeon, Assistant & Anaesthetist Fees)
Medicare rebates apply to surgeon & anaesthetist fees after the surgery has been performed. Subsequent appointments within the clinic will attract a fee that is rebateable from Medicare.
*High-risk patients and those seeking revisional surgery will not be considered without private health insurance.
Meet patient Nola Sargeant. She struggled with the merry go round of dieting, losing weight and putting it back on again.
“I just knew it was the correct thing to do and after meeting Patrick, I didn’t even bother looking elsewhere as he just made me feel so comfortable throughout all my procedures. The entire team here definitely care about myself as a patient and also as a person.”
Meet patient Suzette. After hearing her friends joke about going on The Biggest Loser TV show she realised it was time for a serious change.
“The impact from having the surgery has been enormous – I’ve lost half my body weight. I’ve gone from being afraid of sitting on chairs for the fear of them collapsing underneath me to now walking into any clothing store and buying whatever I want. And 11 years later the team are always there for me – they are always welcoming and always helpful, nothing is ever a problem!”
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